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Expert Article: Nutritional Care And Challenges In Feeding A Patient With Alzheimer’s
Age-related changes in addition to a person's ability to function can be quite a challenge in maintaining adequate nutrition in seniors with Alzheimer's. In the modern world of nuclear family settings, the aged spouse who is usually the caretaker can face a multitude of challenges in feeding a loved one.
Persons with Alzheimer's usually forget to eat, do not recall when they had their last meal or snack, assume they have eaten, cannot communicate they are hungry or thirsty, difficulty in chewing or swallowing, dentures not fitting, loss of appetite due to medications and the list goes on for the causes of malnutrition.
Some Important Points For Caregivers To Encourage Eating And Their Nutrition
It is important to remember there is no special diet for Alzheimer's unless they have another health condition like diabetes, blood pressure, heart condition etc. It is important to serve nutrient-dense small meals that are appealing to the eye and has an aroma.
- Allow the person to eat when they are alert and not fixed on meal timings
- Try small portions on a plate. Do not expect them to finish the meals served.
- Do not clear the plate if there is a long gap between eating as they would have simply forgotten to eat from the plate before them, gently coax them or remind them
- Remove distractions during mealtimes like television or mobiles
- They cannot judge food temperatures so serve them warm food and not too hot.
- Try finger foods and small bite-size portions
- Cut the foods into small sizes which is easier to feed themselves if they can, e.g., baby idlis soaked in sambar, bite-size dosas or chapattis in small pieces soaked in patla dhal or gravy
Nutritious Foods To Include:
Include all food groups in a day for ensuring they get a balanced diet with both macro and micronutrients.
- Fruit puree, fruit popsicles, fruit smoothies
- Soft-cooked vegetables (less chewing and easy to swallow), well-cooked vegetables in small pieces in a gravy-like a kootu, khadi with vegetables, thick sambar with vegetables
- Soft well-cooked legumes like rajma, channa- if necessary, mash them with a potato masher. If it causes flatulence while soaking in water overnight add a 1-inch piece of ginger. Add fewer spices in the gravy for better tolerance
- Can include thick milk with turmeric for a warm drink, can add in thick conjees, in Kheer, serve their favourite chai or coffee twice a day. If there is intolerance to milk substitute with almond milk or soy milk
- Soft boiled eggs, poached eggs or omelettes in bite-size pieces
- Grilled fish or chicken in small bite-size portions or gravy
- For persons with sweet tooth serve warm brownies, moong dhal kheer, payasam, soft sweets like rasagolla, malai sweets - all made with dates or palm jaggery
- Well-cooked soft rice like Khichdi with rasam, or soupy consistency, bisibela bath with mashed vegetables
- Soft parathas stuffed with sweet potato or radish which is easier to chew or swallow with curd or mishti doi or shrikhand
On A Final Note...
Remember patience at food times will go a long way in helping them eat better. Do not forget to hydrate them with milk, curd, buttermilk, soups, rasam, fruit smoothies (loaded with fibre than juices), and tender coconut water and of course water. It is a daily challenge for all caregivers in ensuring the right nutrition for their loved ones, but small changes in their diet and variety will help them eat better. Reach out to a qualified dietitian for a personalized meal plan
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